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Hayato Mitamura, Takayuki Baba, Toshiyuki Oshitari, Eiju Sato, Shuichi Yamamoto; Effect Of Intraretinal Bevacizumab Before Vitrectomy On Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3280.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the postoperative BCVA and surgical complications after pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) using intravitreal bevacizumab (IVB) as an adjunct.
A retrospective, consecutive, non-comparative, interventional case series. One hundred seventeen eyes of 106 PDR patients that received 1.25 mg IVB 3 days before PPV were studied. PPV was carried out with 20G or 23G vitrectomy instruments with phacoemulsification and implantation of an intraocular lens. The main outcome measures were the BCVA and postoperative surgical complications. All cases were followed for 6 months.
The average age of the patients was 52.7 ± 12.6 years. Preoperatively, vitreous hemorrhage (112 eyes, 95.7%), tractional retinal detachment (52 eyes, 48.7%), and neovascular glaucoma (7 eyes, 6.0%) were present. The BCVA improved from 1.65 ± 0.81 to 0.60 ± 0.63 logMAR units at six months postoperatively (P < 0.001). The average intraocular pressure was not changed significantly during the postoperative period of 6 months (15.3 ± 3.6 vs 16.3 ± 6.1 mmHg, P=0.162). Postoperatively, vitreous hemorrhage was presented in 4 eyes (1.4%), rhegmatogenous retinal detachment in 2 eyes (1.7%), and neovascular glaucoma in 9 eyes (7.7%). Eyes with vitreous hemorrhage and rhegmatogenous retinal detachment were successfully treated by a second vitrectomy. In the nine eyes with postoperative neovascular glaucoma, 2 eyes had neovascular glaucoma and 4 eyes had a severe tractional retinal detachment preoperatively. Two -thirds of the cases with postoperative neovascular glaucoma had BCVA 20/200 at the final visit.
PPV with IVB as an adjunct had relatively good BCVA with fewer recurrent vitreous hemorrhages. However, eyes that developed neovascular glaucoma postoperatively had poor final BCVA.
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